Ann Surg Treat Res.  2021 Nov;101(5):274-280. 10.4174/astr.2021.101.5.274.

Short- and long-term outcomes of laparoscopic segmental left colectomy for splenic flexure colon cancer: comparison with propensity score matching

• Kim MJ
• Kim JH
• Lee YS
• Kye BH
• Cho HM
• Kim HJ
• Kang WK

• KMID: 2521849
• DOI: http://doi.org/10.4174/astr.2021.101.5.274

Abstract

Purpose
Splenic flexure colon cancer (SFCC) is a rare disease that accounts for 2%–8% of colorectal cancers, and the extent of surgery and resection is still debatable. There have also been few studies on the safety and feasibility of laparoscopic surgery for SFCC. The purpose of this study is to evaluate outcomes and prognoses of surgery for SFCC.
Methods
We included patients with stage 1 to 3 who had undergone laparoscopic surgery for distal transverse-to-sigmoid colon cancer at 2 hospitals from March 2004 to December 2016 and collected data by retrospective design. We defined SFCC as being cancer between distal transverse and proximal descending colon. The short- and long-term outcomes of the anterior resection (AR) group (those patients who had undergone laparoscopic AR for mid and distal descending to sigmoid colon cancer) and the left colon resection (LR) group (those who had undergone laparoscopic segmental left colectomy for SFCC) were compared using propensity score matching.
Results
The median follow-up period was 60 months. The numbers of subjects in the AR and the LR groups were 948 and 118. After 2:1 propensity score matching, 236 vs. 118 patients were selected. There was no significant difference in 5-year disease-free survival (80.7% vs. 78.6%, P = 0.607), and both the 5-year overall survival (89.2% vs. 88.2%, P = 0.563) as well as short-term outcomes showed no statistical difference in most of the variables.
Conclusion
Laparoscopic segmental left colectomy can be one option among the standard procedures for SFCC.

Keyword

Colectomy; Colon cancer; Splenic flexure

Figure

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  Fig. 1 Laparoscopic segmental left colectomy procedure. (A) Ligation of left colic artery. (B) Ligation of middle colic artery left branch. (C) Laparoscopic segmental left colectomy specimen.

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  Fig. 2 Disease-free survival. AR, anterior resection; LR, left colon resection.

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  Fig. 3 Overall survival. AR, anterior resection; LR, left colon resection.

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